Microsurgery is a surgical technique for operating on minute structures which require magnification to see the detail of the anatomy, with specialized, miniaturized precision instruments. Microsurgery permits operations that were once virtually impossible, including, for example, removal of tumors intricately involved with vital eloquent structures of the brain. These types of procedures require safely cutting or manipulating certain structures to cut, move or hold them during a procedure without damaging them or collateral tissues. Due to the delicate nature of the structures involved, the design of suitable surgical instruments for these types of procedures presents certain challenges.
For example, because the need to create a narrow and often deep surgical corridor to access the structures being subject to the operation are in the same focal corridor and surgical site. Often these tissues are difficult to differentiate the normal from the abnormal tissue, many known surgical device have line of sight issues whereby the shaft and/or the effector end of the instrument is very difficult to observe during a procedure without also occluding the surgeons view of the surgical site. As a result, users are often required to hold the instrument at awkward angles so as to maintain visibility during the procedure, which may lead to unintended movements by the operator causing harm to normal tissues. Often because of the size and angle at which the instrument must be entered into the surgical site, the actual use of the instrument blocks the surgeons view of the surgical site during its use and the surgeon effectively uses the instrument “blindly” and removes the instrument from the surgical field so as to inspect the outcome of the use of the instrument. If unsatisfactory, then the instrument is then placed again in the surgical field for additional work. This can often go on for multiple passes the surgical site. Such repeated action can cause damage to the tissues which line the surgical corridor due to the bumping of the instrument as they are passed in and out, this results in procedural inefficiency as well as increased surgeon fatigue.
Manipulation of the microsurgical device is also difficult within the surgical field. For example, while a device may be configured to cut tissue or grasp different structures, often there is no mechanism to change angles of orientation of the effector end of the device during the cutting or grasping operation while it is in use within the surgical site. In cases where these accommodations have been made to an instrument they have been created for use with endoscopic imaging and not been designed for use with microscopic or exoscopic imaging modalities. Accordingly, the user has traditionally been required to extract the device from the surgical field to reposition the device for further operation or remove the device and request that a different angled device be provided. This action thus lengthens a procedure. Moreover, depending on the set up in the operating suite, in some instances the repositioned angle requires the user to hold and operate the device in an awkward manner, also leading to fatigue and an unintended impact to the tissues within the surgical site.
Based on the foregoing, an improved device that allows for easy manipulation for both line of sight issues, as well as to permit flexibility of use during a procedure.